| NPI | 1922893635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MN 12980) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2307536) |
| Enumeration Date | 2025-04-12 |
| Last Update Date | 2025-06-30 |